[How the financial resources of health centre management committees in Burkina Faso can be used to improve equity of access to health care].

With the advent of cost-recovery system in the 1990s in Burkina Faso, patients contribute to the financing of health centres (CSPS), which are managed by management committees (COGES). Asking patients to pay, however, erects a financial barrier to treatment for the poorest. The aim of this paper is to study how the financial resources from cost recovery can be used to improve equity of access to health care. The study took place in the health district of Ouargaye and documents the financial position of 17 COGES over a period of 12 months, with their accounting data. The results show that COGES spent an average of 7 million francs CFA, 65% for the purchase of medicines, 15% for operating costs, 7% for staff salaries and bonuses to COGES and 3.4% for discounts for health workers. Average revenue per COGES was 7.3 million FCFA. The sale of generic drugs accounted for 82% of revenue and fees for medical care to 10%. The average profit was 300,000 FCFA. The cost recovery rate averaged 104% and the profit margin on the sale of drugs 31%. Discounts to health workers represented 30% of the revenues from medical fees. The average cash position of a COGES was 3.1 million FCFA. The financial standing of the COGES is thus good. They could improve access to care and provide the standards discount to employees (20%) by removing fees for services, reducing the margins on the sale of drugs, or by using a portion of profits to exempt the poorest from payment.